As the summer comes to a close, it is time for us to keep you updated on what is occurring in the world of Michigan's No-Fault auto insurance law. This newsletter focuses not only on news about M & T, but on some of the important political processes underway that threaten our precious No-Fault system and the wonderful benefits available to Michigan's auto accident injured population. In addition, Wayne Miller, speaks out on barrier free home accommodations and transportation. As always you should feel free to call us with any questions you may have. We never charge for an initial consultation or to answer basic No-Fault questions. Please also visit our website at www.millertischler.com for more details about our legal family.

Sincerely,

M & T Legal Team

Firm News

M & T ABOUT TOWN

M&T has been named in the 2011-2012 US News Best Lawyers "Best Law Firms" rankings.

Once again, Wayne Miller has been selected as a Michigan Super Lawyer for 2011. Only the top 5% of Michigan lawyers are included in this ranking system.

Wayne Miller will be co-moderator of the Michigan Association of Justice's annual No-Fault Institute, to be held September 8-9, 2011. Maureen Kinsella will be speaking on the subject of barrier free home accommodations and modified vehicles.

Wayne Miller will be speaking at the State Bar of Michigan/Institute of Continuing Legal Education's annual No-Fault Update on October 13, 2011 on the subject of medical causation under the No-Fault Law.

Maureen Kinsella is scheduled to speak at ICLE as well on issue of litigating No Fault cases in Federal Court.

MILLER & TISCHLER WELCOMES ROBERT E. DICE, JR. TO THE FIRM

It is with great pleasure that we announce that Robert E. Dice, Jr. has joined the M & T legal team. Rob is an experienced trial attorney with a law practice focused on the Michigan No-Fault Law. During his twenty-five year legal career, he has handled cases for both injured plaintiffs and insurance company defendants. For the past nine years, his practice has been limited to matters involving injury victims and medical providers seeking their rights under the Michigan No-Fault Act.

Rob is a member of the State Bar of Michigan and the Michigan Association for Justice. He frequently presents seminars to attorneys, medical groups and other audiences on various aspects of the Michigan No-Fault law. He practices in courts throughout the state of Michigan.

Rob was admitted to the practice of law in 1986. He received his law degree from Detroit College of Law. Before attending law school he earned a BA in English at Calvin College in 1983. He also attended U of M in 2001-2002 working toward an MA/Teaching degree.

Legal Decisions and Verdicts

PIP CHOICE LEGISLATION UNDER CONSIDERATION

By far the most disturbing of all of the ominous developments this summer is the specter of "PIP Choice." The legislature has been considering whether to end our current system of mandatory unlimited medical benefits and replace it with a system where the insured can choose coverage limits down to $50,000. While the concept of choice is superficially appealing, the reality is that such a system would destroy much of what has been unique and wonderful about the No-Fault law. Many people would choose the lowest coverages and thus be unable to pay for long term care and rehabilitation for brain and spinal cord injuries. The industries that serve the severely injured would be devastated. It is time to call your legislators and register your urgent and profound disagreement with this concept. To find out who your state representative and senator are, click on the following link: http://capwiz.com/biami/state/main/?state=MI.

NEW SUPREME COURT ALERT

REGARDING THE NO-FAULT WORLD

We hope you are enjoying the very warm summer weather that we've been having. Developments in the No-Fault world are even hotter. The new Supreme Court has been asserting itself already, and we expect that the new legislature will be doing likewise. Key developments include:

Protections for the disabled against the one year back rule are threatened. The Regents case is currently the law, and holds that the No-Fault one year back rule does not run against minors and the mentally disabled. The new Supreme Court has granted leave in a case called Joseph v. ACIA. We are greatly concerned that the Court will remove the protections currently enjoyed by the most vulnerable in our society.

Experimental services are not compensable under the No-Fault law. The Supreme Court reversed the Court of Appeals in Krohn v. Home Owners Insurance Company. The Supreme Court held that stem cell transplant surgery for spinal cord patients was experimental and therefore not compensable under the No-Fault law. "A treatment or procedure that has not been shown to be efficacious cannot be reasonable or necessary under the no-fault act. An insured's subjective belief that medical treatment is efficacious, reasonable, and necessary is not enough to create a question of fact."

U.S. DISTRICT COURT AWARDS PROVIDERS

SUBSTANTIAL NO-FAULT PENALTIES IN PRIORITY DISPUTE

On July 26th the United States District Court for the Eastern District of Michigan awarded two provider clients over $150,000.00 in No-Fault penalties.In this case, the providers reimbursement was delayed more than a year as a result of a priority dispute.Mark Schreier represented our clients, a hospital and two in-patient rehabilitation facilities, who incurred over $400,000.00 in expenses while caring for a young man that had been struck by a vehicle.At the time of the incident, the young man resided in a group home.

The providers promptly presented their claims to the insurer of the vehicle that struck the patient, originally, the only known insurer. The vehicle's insurer refused to pay until it confirmed that it was the highest priority insurer.Months passed, and the vehicle's insurer made little effortto investigate the existence of additional insurance, specifically whether the group home had a policy that covered its resident. Meanwhile, the providers' bills went unpaid. The providers eventually retained Miller & Tischler, and we filed suit against the vehicle's insurer on the basis that the possible existence of a higher priority insurer was not a reason to withhold payment if the injured person is otherwise entitled to No-Fault benefits.

Eventually Mark identified the commercial auto insurer of the group home where the patient resided.The language of its policy identified the patient/resident as a ward and further indicated that a ward was a family member and therefore eligible for coverage under the policy. Shortly thereafter, the group home's insurer admitted that it was the highest priority insurer. Nevertheless, another 6 months passed before the group home insurer issued practically 100% reimbursement to the providers.

The parties filed cross motions for summary judgment on the issue of No-Fault penalties. The District Court found for our clients and awarded over $112,000.00 in No-Fault attorney fees and over $41,000.00 in penalty interest.While the Court's opinion found the insurers jointly liable for the attorney fees, it held that the vehicle's insurer, the lower priority insurer, was responsible for more than 50% of the penalty interest based on its receipt of reasonable proof of the fact and amount of loss many months before identification of the higher priority insurer.

The Court's Opinion affirms the longstanding principle that a priority dispute is not an exception to the prompt pay requirement of the No-Fault Act.It is unreasonable for an insurer to refuse payment of benefits when the only question is which of two insurers will pay.The Court's Opinion also notes the distinction between presenting "reasonable proof of the fact and amount of loss sustained" under MCL 500.3142, and the additional proofs necessary to prove a claim under MCL 500.3107(1).The Court found that the providers' submission of their bills and "copious medical records" demonstrated both the fact of the loss and the amount of the loss, thereby mandating an award of penalty interest against both insurers.

Ask Wayne

What if my home is not handicap

accessible?

Few homes are originally built barrier-free or handicap accessible. Thus, most homes require modification to meet your needs if you are catastrophically injured. Ramps, lifts, emergency exits, bathroom facilities, accessible kitchens and much more may be needed. Should your injuries require special accommodation, your No-Fault insurer is obligated to pay for all reasonably necessary modifications. To read the actual statute identifying home modifications as a compensable benefit click here.

Testimonials

"Mark: We truly cannot express the full extent of our gratitude. Your professionalism, honesty, integrity, and knowledge of the law are so very impressive. We have a very large file with your name on it and would not hesitate to recommend you or your firm to anyone in need of legal assistance. While we hope to never be in need of legal counsel again, you have renewed our faith in the trust that is a vital part of the lawyer-client relationship. Prompt response to any and every question we had, no matter how trivial, gave us the peace of mind needed to proceed with our case. You pushed when we needed pushing, listened when we talked, and responded on a level we could fully understand and appreciate. We are very grateful to be in a position where we can now put our case behind us and truly move on with no regrets. We want to thank you for that peace of mind." - Jeff and Marcia L., Traverse City.

Miller & Tischler, P.C., represents survivors of catastrophic brain and spinal injuries, their families and their professional service providers who are having difficulty pursuing their entitlement to receive No-Fault benefits for injuries sustained in motor vehicle accidents. We help our clients understand how their No-Fault insurance may coordinate with other kinds of insurances they have whether it be private health insurance, Medicaid, Medicare, Workers' Compensation, or Veterans benefits. We also assist our clients in learning about and obtaining all of the benefits to which they are entitled, whether they be individuals or service providers.